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HH Maintenance Venesection — RACP Adult Medicine MCQ

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EasyGastroenterologyHH Maintenance VenesectionRACP Adult Medicine

A 50-year-old C282Y homozygous woman with ferritin 2500 μg/L has been undergoing weekly venesection. After 6 months, ferritin has normalised to 80 μg/L. TSAT is 30%. She feels well. What is the most appropriate ongoing management?

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Correct answer: B — Repeat iron studies in 6 months

After successful iron depletion (ferritin <100 μg/L), the patient transitions to maintenance venesection. Frequency is individualised (typically every 2-4 months) guided by ferritin levels. Target: maintain ferritin 50-100 μg/L. Repeat iron studies every 3-6 months to guide venesection frequency. Lifelong monitoring and maintenance venesection are required — iron re-accumulates on a normal diet.

Reference: GESA – 2024 – Haemochromatosis Maintenance